Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $222.74 / $277.63 / $433.10	Professional		$222.74	$277.63	$433.10
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.98 / $43.62 / $131.35	Professional	26	$31.98	$43.62	$131.35
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $174.01 / $238.59 / $772.00	Professional	TC	$174.01	$238.59	$772.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $140.54 / $140.54 / $293.27	Professional		$140.54	$140.54	$293.27
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.43 / $18.43 / $38.45	Professional	26	$18.43	$18.43	$38.45
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $122.11 / $122.11 / $254.81	Professional	TC	$122.11	$122.11	$254.81
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $315.19 / $315.19 / $414.15	Professional		$315.19	$315.19	$414.15
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $47.63 / $47.63 / $63.74	Professional	26	$47.63	$47.63	$63.74
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $267.56 / $267.56 / $350.41	Professional	TC	$267.56	$267.56	$350.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.66 / $183.46 / $535.24	Professional		$100.66	$183.46	$535.24
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.93 / $25.29 / $75.23	Professional	26	$18.93	$25.29	$75.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $78.25 / $160.44 / $469.49	Professional	TC	$78.25	$160.44	$469.49
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $260.36 / $338.47 / $388.66	Professional		$260.36	$338.47	$388.66
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $38.97 / $46.85 / $54.57	Professional	26	$38.97	$46.85	$54.57
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $221.38 / $287.79 / $335.43	Professional	TC	$221.38	$287.79	$335.43
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $66.25 / $66.25 / $125.80	Facility	26	$66.25	$66.25	$125.80
Medcost Facility/Professional Professional Modifier Low / Median / High Price $57.00 / $366.00 / $625.00	Professional		$57.00	$366.00	$625.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $59.60 / $263.97 / $641.07	Professional		$59.60	$263.97	$641.07
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $51.52 / $62.06 / $95.43	Professional	26	$51.52	$62.06	$95.43
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $40.97 / $289.22 / $667.42	Professional	TC	$40.97	$289.22	$667.42
United Facility/Professional Professional Modifier Low / Median / High Price $158.16 / $294.45 / $551.42	Professional		$158.16	$294.45	$551.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.63 / $46.05 / $84.02	Professional	26	$27.63	$46.05	$84.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $126.69 / $234.70 / $483.31	Professional	TC	$126.69	$234.70	$483.31